【素】夫脉者。血之府也。（荣行脉中。刺志论曰。脉实血实。脉虚血虚。）长则气治。（长为气足。）短则气病。（短
为不足。）数则烦心。（数疾为热。）大为病进。（大为邪盛。）上盛（寸口。）则气高。下盛（尺中。马注谓寸下。即关也。
盖以胀满属中部。昂按。肾亦有胀。）则气胀。（肾者。胃之关。关门不利。故胀。）代则气衰。（动而中止。曰代。）细则
气少。涩则心痛。（涩为血少。）浑浑革至如涌泉。（甲乙脉经。皆作浑浑革革。至如涌泉。）病进而色弊。绵绵其去如弦
绝死。（脉微而复绝。）（脉要精微论）
【素】何谓虚实。曰。邪气盛则实。精气夺则虚。虚实何如。曰。气虚者。肺虚也。（肺主气。）气逆者。足寒也。
（上
盛下虚。）非其时则生。（非相克之时。）当其时则死。（遇相克之时。）余藏皆如此。所谓重实者。言大热病。气热脉满。
是谓重实。经络皆实。是寸脉急而尺缓也。（寸急为阳经实。尺缓为阴络实。王注。阴分主络。阳分主经。）滑则从。涩
则逆也。故五脏骨肉滑利。可以长久也。（凡物死则枯涩。）络气不足。经气有余者。脉口热（寸口。）而尺寒也。秋冬为
逆。春夏为从。治主病者。（春夏阳气高。故脉口宜热。尺中宜寒。当察其何经何络所主而治之。）经虚络满者。尺脉满。
脉口寒涩也。此春夏死。秋冬生也。（秋冬阳气下。故尺中宜热。脉口宜寒。）何谓重虚。曰。脉气上虚尺虚。是谓重虚。
（寸尺皆虚。）如此者。滑则生。涩则死也。肠 便血何如。（肠风下痢。皆名肠 。此问似专指下痢。观下文可见。便
血。纯血也。为热伤血分。）身热则死。寒则生。肠 下白沫何如。（非脓非血。而下白沫。为热伤气分。）脉沉则生。脉
浮则死。（浮为阴症见阳脉。大抵痢疾。忌身热脉浮。）肠 下脓血何如。（赤白相兼。气血俱伤。）脉悬绝则死。滑大则
生。（滑为阴血。大为阳气。）癫疾何如。脉搏大滑。久自已。（阳证得阳脉。）脉小坚急。死不治。（阳证得阴脉。）癫疾
之脉。虚实何如。虚则可治。实则死。（实为邪盛。）消瘅（胃热消谷善饥。）虚实何如。脉实大。病久可治。（血气尚盛。）
脉悬小坚。病久不可治。（通评虚实论）
【素】寸口之脉中手短者。曰头痛。中手长者。曰足胫痛。（王注。短为阳不足。故病在头。长为阴太过。故病在足。）
寸口脉。中手促。上击者。曰肩背痛。（阳盛于上。）寸口脉。沉而坚者。曰病在中。浮而盛者。曰病在外。寸口脉。沉
而横。曰胁下有积。腹中有横积痛。寸口脉。沉而喘。曰寒热。（沉为阴。喘为阳。当寒热往来。）脉盛滑坚者。曰病在
外。脉小实而坚者。曰病在内。脉小弱以涩。谓之久病。（小弱为气虚。涩为血虚。）脉滑浮而疾者。谓之新病。（气足阳
盛。）脉急者。曰疝瘕。少腹痛。（急为寒。为痛。）脉滑曰风。（滑为阳脉。风亦阳邪。）脉涩曰痹。（涩为无血。故痹。）
缓而滑曰热中。（胃热。）盛而紧曰胀。（紧为寒胀。）尺脉缓涩。谓之解 。（张注。懈堕。）安卧脉盛。谓之脱血。（安卧
脉应微而反盛。血去而气无所主。）尺涩脉滑。谓之多汗。（血少而阳有余。）尺寒脉细。谓之后泄。（肾主二便。虚寒则
不能禁固。）尺粗常热者。谓之热中。（王注。中谓下焦。）（平人气象论）
【素】心脉搏坚而长。当病舌卷不能言。（脉击手曰搏。舌为心苗。心火盛。故然。）其 而散者。当消环自已。（王
注。诸脉 散。为气实血虚。消谓消散。环谓环周。张注。消谓消渴。非。）肺脉搏坚而长。当病唾血。（血随火而逆上。）
其而散者。当病灌汗。至令（一作今。）不复散发也。（脉虚多汗。将惧亡阳。不能更任发散。马注。作一散之则病已。
非。）肝脉搏坚而长。色不青。当病坠若搏。（坠堕搏击所伤。色不应脉。病在外伤。）因血在胁下。令人喘逆。（肝主胁。
损伤血积胁下。上薰于肺。则喘逆。）其 而散。色泽者。当病溢饮。溢饮者。渴暴多饮。而易入肌皮。肠胃之外也。（血
虚中湿。水液不消。）胃脉搏坚而长。其色赤。当病折髀。（胃脉下髀。故髀如折。）其 而散者。当病食痹。（胃虚。故
痹闷难消。）脾脉搏坚而长。其色黄。当病少气。（脾不和。肺无所养。故少气。）其 而散。色不泽者。当病足 肿。若
水状也。（脾主四肢。脉下足 。脾虚不运。故肿。）肾脉搏坚而长。其色黄而赤者。当病折腰。（王注。色黄而赤。是心
脾干肾。腰为肾府。故如折。）其 而散者。当病少血。至令（一作今。）不复也。粗大者。阴不足。阳有余。为热中也。
来疾去徐。上实下虚。（上实故来疾。下虚故去迟。）为厥巅疾。（邪气上实为 仆。及巅顶之疾。）来徐去疾。上虚下实。
为恶风也。故中恶风者。阳气受也。（风为阳邪。上虚故先受。）有脉俱沉细散者。少阴厥也。（沉细为肾脉。数为热。王
注。尺脉不当见数。沉细而数。当为热厥。）沉细数散者。寒热也。（沉细为阴。数散为阳。当病寒热。）浮而散者。为
仆。（浮为虚。散为无神。故眩仆。）诸浮不躁者。（虽浮而未至躁。）皆在阳。则为热。（浮为阳。浮而不躁。为阳中之阴。
其病在足阳经。）其有躁者在手。（若兼躁。则火上升。为阳中之阳。病在手经矣。躁即浮之甚也。）诸细而沉者。皆在阴。
则为骨痛。（沉细为阴脉。阴主骨。主痛。）其有静者在足。（深沉之甚也。则病在下部足阴经矣。）数动一代者。病在阳
之脉也。泄及便脓血。（代为气衰。然有积者。亦脉代。故主泄利便血。马注。数字读作入声。数为热。故便血。非。）
涩者。阳气有余也。滑者。阴气有余也。阳气有余。为身热无汗。（气多血少。）阴气有余。为多汗身寒。（阳虚阴盛。）
阴阳有余。则无汗而寒。（阳有余。故无汗。阴有余。故身寒。）（脉要精微论）
【素】心脉满大。痫螈筋挛。（痫螈音酣异。火盛生风。而眩仆抽掣也。）肝脉小急。痫螈筋挛。（血虚故小。受寒故
急。血虚火盛为痫螈。急为筋挛。）肝脉骛暴。（驰骛暴乱。）有所惊骇。脉不至。若喑。不治自已。（骛骇则脉阻而气壅。
故不能言。气复自已。）肾脉小急。肝脉小急。心脉小急不鼓。皆为瘕。（小急为虚寒。不鼓为血不流。故内凝为瘕）肾
肝并沉为石水。（沉为在里。小腹坚胀如石。）并浮为风水。（浮为在表。蓄水胃风。发为浮肿。）并虚为死。（肾为五脏之
根。肝为生发之主。）并小弦欲惊。（弦小为虚。）肾脉大急沉。肝脉大急沉。皆为疝。（瘕疝皆寒气之所结聚。脉大为虚。
急为寒。沉为在里。故前小急者为瘕。此大急沉者。亦为疝也。）心脉搏滑。急为心疝。（脉要精微论。心脉急为心疝。
有形在于少腹。其气上搏于心。）肺脉沉搏为肺疝。（肺脉当浮。今沉而搏。为寒气薄于脏。）三阳急为瘕。三阴急为疝。
（三阳。太阳膀胱。三阴。太阴脾也。王注。受寒血聚为瘕。气聚为疝。马注。二病皆气血相兼。）二阴急为痫厥。二阳
急为惊。（二阴。少阴肾。二阳。阳明胃也。皆为寒。）脾脉外鼓沉为肠 。久自已。（吴注。沉为在里。外鼓有出表之象。）
肝脉小缓为肠 。易治。（缓为脾脉。脾乘肝为微邪。小缓为脉渐和。）肾脉小搏沉。为肠 下血。（小为阴气不足。搏为
阳热乘之。沉为在下。故下血。）血温身热者死。（凡下痢下血下沫。皆名肠 。俱忌身热。）心肝 亦下血。（心生血。
肝藏血。移热于肠而 。）二脏同病者。可治。（木火相生。）其脉小沉涩为肠 。（心肝二脉。小而沉涩。亦为寒 。）其
身热者死。（阴气内绝。虚阳外脱。）胃脉沉鼓涩。（沉不当鼓。鼓不当涩。是血虚而有火也。）胃外鼓大。（是阳盛而阴不
足也。）心脉小坚急。（小为血虚。坚为不和。急为寒盛。）皆膈偏枯。（人身前齐鸠尾。后齐十一椎。有膈膜。所以遮隔
浊气。使不上薰心肺。今膈有病。则隔拒饮食。故即以膈名病也。偏枯者。半身不遂。血气不能周通。胃病则不能纳谷。
心病则不能生血。故为膈症偏枯也。）男子发左。女子发右。不喑舌转。可治。（少阴之脉侠舌本。邪未入肾。犹可治。）
脉至而搏。血衄身热者死。（鼻血曰衄。亡血阴虚。脉最忌搏。身最忌热。）脉来悬钩浮。为常脉。（为邪在表。乃衄家之
常脉。）（大奇论）
【灵】诸病皆有逆顺。可得闻乎。腹胀。身热。脉大。是一逆也。腹鸣而满。四肢清（冷）泄。其脉大。是二逆也。
衄而不止。脉大。是三逆也。（皆为阴症见阳脉。）咳且溲（小便。）血。脱形。其脉小劲。（小不宜劲。）是四逆也。咳脱
形。身热。脉小以疾。（小不宜疾。）是谓五逆也。如是者。不过十五日而死矣。其腹大胀。四末清。脱形泄甚。是一逆
也。腹胀便血。其脉大时绝。是二逆也。咳（上。）溲血。（下。）形肉脱。（外。）脉搏。（内。）是三逆也。呕血。胸满引
背。脉小而疾。（虚而火盛。）是四逆也。咳呕。（上。）腹胀。（中。）且飧泄。（下。）其脉绝。是五逆也。如是者。不及
一时而死矣。（玉版）
【灵】何谓五逆。热病脉静。（阳症见阴脉。）汗已出。脉盛躁。（病不为汗衰。）是一逆也。病泄。脉洪大。是二逆
也。着痹不移。 肉破。身热。脉偏绝。是三逆也。淫而夺形。身热。色夭然白。及后下血 。（凝黑。）血 重笃。是
谓四逆也。寒热夺形。脉坚搏。（真藏脉见。）是谓五逆也。（五禁）
【灵】诸急者（脉急。）多寒。缓者多热。（按热当属数。）大者多气少血。小者气血皆少。滑者阳气盛。微有热。涩
者多血少气。（按涩当为血少。）微有寒。诸小者。阴阳形气俱不足。（邪气脏腑病形。）
【灵】一日一夜五十营。（昼行阳二十五度。夜行阴二十五度。）以营五脏之精。不应数者。名曰狂生。（犹言幸生。）
所谓五十营者。五脏皆受气。持其脉口。数其至也。五十动而不一代者。五脏皆受气。（动而中止为代。）四十动一代者。
一脏无气。三十动一代者。二脏无气。二十动一代者。三脏无气。十动一代者。四脏无气。不满十动一代者。五脏无气。
予之短期。（知其将死。）（根结。）
【素】脉从而病反者。其诊何如。曰。脉至而从。按之不鼓。诸阳皆然。（此阳盛格阴之症也。内热甚而脉反不鼓。
是阳盛极。格阴于外。非真寒也。王注。此作非热也。下作非寒也。似与经文颠倒。）诸阴之反。其脉何如。曰。脉至而
从。按之鼓甚而盛也。（此阴盛格阳之症也。内寒而脉反鼓甚。是阴盛极。格阳于外。非真热也。二症最为惑人。医者慎
之。）（至真要大论）
【素】人迎一盛。病在少阳。二盛病在太阳。三盛病在阳明。（左手寸口脉名人迎。主手足六阳经腑病。）四盛以上
为格阳。（一盛。人迎大于气口一倍也。仲景云。格则吐逆。王注。阳盛之极。格拒食不得入。东垣云。格者。甚寒之气。
马注。格六阴在内。使不得出。）寸口一盛。病在厥阴。二盛病在少阴。三盛病在太阴。四盛以上为关阴。（右手寸脉名
寸口。主手足六阴经脏病。一盛。寸口大于人迎一倍也。仲景云。关则不得小便。王注。阴盛之极。关闭溲不得通。东
垣云。关者。甚热之气。马注。关六阳在外。使不得入。）人迎与寸口俱盛。四倍以上为关格。关格之脉赢。不能极于天
地之精气。则死矣。（新校正云。赢当作盈。乃盛极也。非羸弱也。灵枢禁服篇。寸口主内。人迎主外。两者相应。俱往
俱来。若引绳大小齐等。春夏人迎微大。秋冬寸口微大。名曰平人。又终始篇。人迎一盛。病在足少阳。一盛而躁。病
在手少阳。人迎二盛。病在足太阳。二盛而躁。病在手太阳。人迎三盛。病在足阳明。三盛而躁。病在手阳明。人迎四
盛。且大且数。名曰溢阳。溢阳为外格。脉口一盛。病在足厥阴。一盛而躁。在手心主。脉口二盛。病在足少阴。二盛
而躁。在手少阴。脉口三盛。病在足太阴。三盛而躁。在手太阴。脉口四盛。且大且数者。名曰溢阴。溢阴为内关。内
关不通。死不治。人迎与太阴脉口俱盛。四倍以上命曰关格。关格者。与之短期。王冰素问注。言足经而不及手经。仲
景东垣丹溪。皆以关格为病症。马玄台非之。而以关格为脉体。昂谓若以为病症。当不止于膈食便闭二症。若以为脉体。
则内经脉经及诸家经论。并无所根据。且有是脉者。必有是病。马氏何不实指其病为何等乎。）（六节藏象论）
【素】何以知怀子之且生也。身有病而无邪脉也。（病字。王注解作经闭。昂按。妇人怀子。多有呕恶头痛诸病。然
形虽病而脉不病。若经闭其常耳。非病也。）（腹中论。）
【素】妇人手少阴脉动甚者。妊子也。（王注解作有子。马注解作男妊。昂按。此当指欲娩身时而言也。手少阴。言
【素问】脉，是血液汇聚的府库。（营气行于脉中。《刺志论》说：脉象充实则血实，脉象虚弱则血虚。）脉长表示气机调畅。（脉长代表气足。）脉短表示气机有病。（脉短代表气不足。）脉数表示心中烦乱。（脉数疾代表有热。）脉大表示病势进展。（脉大代表邪气盛。）寸口脉上部（寸部）盛，表示气机上逆；尺中脉下部（尺部）盛，表示气机胀满。（马莳注认为“下”指关部以下。因为胀满属于中部病症。汪昂按：肾脏也有胀满的情况。肾是胃的关口，关口不利，所以产生胀满。）脉代表示气衰。（脉搏动中途停止，称为代脉。）脉细表示气少。脉涩表示心痛。（脉涩代表血少。）脉象浑浊急迫如涌泉般来势汹涌，病势进展且面色败坏。脉象微弱连绵而去，如弓弦断绝，主死。（脉微且中断。）（出自《脉要精微论》）
【素问】什么是虚实？回答说：邪气盛实就是实证，精气耗夺就是虚证。虚实表现如何？回答说：气虚，就是肺虚。（肺主气。）气逆，表现为足部寒冷。（上盛下虚。）在非相克之时则生，在相克之时则死。（遇到五行相克之时。）其他脏腑也都如此。所谓“重实”，是指大热病，气分热盛，脉象满大，这叫做重实。经络都实，表现为寸脉紧急而尺脉缓弱。（寸脉急为阳经实，尺脉缓为阴络实。王冰注：阴分主络，阳分主经。）脉滑顺，脉涩逆。所以五脏骨肉滑利，可以长寿。（凡物死亡则枯涩。）络气不足，经气有余，表现为脉口（寸口）热而尺部寒。秋冬出现这种情况为逆，春夏出现为顺。治疗主要病变的经脉。（春夏阳气高，所以脉口宜热，尺中宜寒。应当观察是哪条经哪条络所主而进行治疗。）经虚络满，表现为尺脉满，脉口寒涩。这种情况春夏主死，秋冬主生。（秋冬阳气下沉，所以尺中宜热，脉口宜寒。）什么是“重虚”？回答说：脉气上部虚、尺部虚，叫做重虚。（寸部和尺部都虚。）像这样的情况，脉滑则生，脉涩则死。肠澼便血情况如何？（肠风下痢，都叫肠澼。这个问题似乎专指下痢，看下文可知。便血，指纯血，是因为热伤血分。）身体发热则死，发冷则生。肠澼下白沫情况如何？（不是脓也不是血，而是下白沫，是因为热伤气分。）脉沉则生，脉浮则死。（浮脉为阴证见阳脉，大抵痢疾忌讳身热脉浮。）肠澼下脓血情况如何？（赤白相兼，气血俱伤。）脉悬绝则死，脉滑大则生。（滑代表阴血，大代表阳气。）癫疾情况如何？脉搏大而滑，时间久了自然痊愈。（阳证得阳脉。）脉小坚急，主死且不可治。（阳证得阴脉。）癫疾的脉象，虚实情况如何？虚则可治，实则死。（实代表邪气盛。）消瘅（胃热消谷善饥）虚实情况如何？脉实大，病久可治。（血气尚盛。）脉悬小坚，病久不可治。（出自《通评虚实论》）
【素问】寸口脉摸起来短的，主头痛。摸起来长的，主足胫痛。（王冰注：短为阳不足，所以病在头；长为阴太过，所以病在足。）寸口脉，摸起来急促，向上冲击手指的，主肩背痛。（阳气盛于上。）寸口脉，沉而坚实的，主病在中焦。浮而盛的，主病在外。寸口脉，沉而横的，主胁下有积块，腹中有横向积块疼痛。寸口脉，沉而喘急的，主寒热往来。（沉为阴，喘为阳，应当是寒热往来。）脉盛滑坚的，主病在外。脉小实而坚的，主病在内。脉小弱且涩的，称为久病。（小弱为气虚，涩为血虚。）脉滑浮且疾的，称为新病。（气足阳盛。）脉急的，主疝瘕，少腹痛。（急为寒，为痛。）脉滑主风。（滑为阳脉，风亦为阳邪。）脉涩主痹。（涩为无血，所以痹。）脉缓而滑主热中。（胃热。）脉盛而紧主胀。（紧为寒胀。）尺脉缓涩，称为懈惰。（张景岳注：懈堕，即懈怠无力。）安静卧息而脉盛的，称为脱血。（安卧时脉应微弱反而盛大，血去而气无所主。）尺部涩而脉滑的，主多汗。（血少而阳有余。）尺部寒而脉细的，主后泄。（肾主二便，虚寒则不能固摄。）尺部粗常热的，主热中。（王冰注：中谓下焦。）（出自《平人气象论》）
【素问】心脉搏击坚实而长，应当病舌卷缩不能说话。（脉击手曰搏。舌为心之苗窍，心火盛，所以这样。）如果脉散漫，应当消散环周自愈。（王冰注：诸脉散，为气实血虚。消谓消散，环谓环周。张景岳注：消谓消渴，非此意。）肺脉搏击坚实而长，应当病唾血。（血随火逆上。）如果脉散漫，应当病灌汗，至今不再散发。（脉虚多汗，将担心亡阳，不能再承受发散疗法。马莳注：作一散之则病已，非此意。）肝脉搏击坚实而长，面色不青，应当病坠堕或搏击所伤。（坠堕搏击所伤，面色不应脉象，病在外伤。）因为瘀血在胁下，使人喘逆。（肝主胁，损伤血积胁下，上熏于肺，则喘逆。）如果脉散漫，色泽润泽的，应当病溢饮。溢饮，是口渴暴多饮水，水液容易进入肌皮、肠胃之外。（血虚中湿，水液不消。）胃脉搏击坚实而长，面色赤，应当病髀骨折断样疼痛。（胃脉下髀，所以髀如折。）如果脉散漫，应当病食痹。（胃虚，所以痹闷难消。）脾脉搏击坚实而长，面色黄，应当病少气。（脾不和，肺无所养，所以少气。）如果脉散漫，色泽不润泽的，应当病足胫肿，像水状。（脾主四肢，脉下足胫，脾虚不运，所以肿。）肾脉搏击坚实而长，面色黄而赤，应当病腰折。（王冰注：色黄而赤，是心脾干肾，腰为肾府，所以如折。）如果脉散漫，应当病少血，至今不再恢复。脉粗大的，阴不足，阳有余，为热中。脉来疾去徐，上实下虚。（上实故来疾，下虚故去迟。）主厥逆和巅顶疾病。（邪气上实导致仆倒，及巅顶之疾。）脉来徐去疾，上虚下实，主恶风。所以中恶风的，是阳气受邪。（风为阳邪，上虚故先受。）脉象都沉细散的，主少阴厥逆。（沉细为肾脉，数为热。王冰注：尺脉不当见数，沉细而数，当为热厥。）沉细数散的，主寒热。（沉细为阴，数散为阳，当病寒热。）浮而散的，主仆倒。（浮为虚，散为无神，所以眩仆。）所有浮而不躁的脉，（虽然浮但未至躁。）都在阳经，则为热。（浮为阳，浮而不躁，为阳中之阴，其病在足阳经。）如果有躁动的，在手经。（若兼躁，则火上升，为阳中之阳，病在手经了。躁即浮之甚也。）所有细而沉的脉，都在阴经，则为骨痛。（沉细为阴脉，阴主骨，主痛。）其中有静静的，在足。（深沉之甚也，则病在下部足阴经了。）脉数动一代的，病在阳之脉，主泄泻及便脓血。（代为气衰，然而有积滞者，亦脉代，所以主泄利便血。马莳注：数字读作入声，数为热，所以便血，非此意。）脉涩的，阳气有余。脉滑的，阴气有余。阳气有余，身体发热无汗。（气多血少。）阴气有余，多汗身寒。（阳虚阴盛。）阴阳都有余，则无汗而身寒。（阳有余，故无汗；阴有余，故身寒。）（出自《脉要精微论》）
【素问】心脉满大，主痫证抽搐筋挛。（痫螈音酣异，火盛生风，而眩仆抽掣也。）肝脉小急，主痫证抽搐筋挛。（血虚故小，受寒故急。血虚火盛为痫证，急为筋挛。）肝脉驰骛暴乱，有所惊骇，脉不至，或者失音，不治自己会好。（骛骇则脉阻而气壅，所以不能言。气复自会好。）肾脉小急，肝脉小急，心脉小急且不鼓动，都为瘕积。（小急为虚寒，不鼓为血不流，所以内凝为瘕积。）肾脉和肝脉都沉，为石水。（沉为在里，小腹坚胀如石。）都浮，为风水。（浮为在表，蓄水胃风，发为浮肿。）都虚，主死。（肾为五脏之根，肝为生发之主。）都小弦欲惊。（弦小为虚。）肾脉大急沉，肝脉大急沉，都为疝。（瘕疝皆寒气之所结聚，脉大为虚，急为寒，沉为在里，所以前小急者为瘕，此大急沉者，亦为疝也。）心脉搏滑，急为心疝。（《脉要精微论》：心脉急为心疝，有形在于少腹，其气上搏于心。）肺脉沉搏为肺疝。（肺脉当浮，今沉而搏，为寒气薄于脏。）三阳急为瘕，三阴急为疝。（三阳，太阳膀胱；三阴，太阴脾也。王冰注：受寒血聚为瘕，气聚为疝。马莳注：二病皆气血相兼。）二阴急为痫厥，二阳急为惊。（二阴，少阴肾；二阳，阳明胃也。皆为寒。）脾脉外鼓沉为肠澼，久自己好。（吴崑注：沉为在里，外鼓有出表之象。）肝脉小缓为肠澼，易治。（缓为脾脉，脾乘肝为微邪，小缓为脉渐和。）肾脉小搏沉，为肠澼下血。（小为阴气不足，搏为阳热乘之，沉为在下，故下血。）血温身热者死。（凡下痢下血下沫，都名肠澼，都忌讳身热。）心肝脉也下血。（心生血，肝藏血，移热于肠而痢。）二脏同病的，可治。（木火相生。）其脉小沉涩为肠澼。（心肝二脉，小而沉涩，亦为寒痢。）其身热者死。（阴气内绝，虚阳外脱。）胃脉沉鼓涩。（沉不当鼓，鼓不当涩，是血虚而有火也。）胃脉外鼓大。（是阳盛而阴不足也。）心脉小坚急。（小为血虚，坚为不和，急为寒盛。）都主膈症偏枯。（人身前齐鸠尾，后齐十一椎，有膈膜，所以遮隔浊气，使不上薰心肺。今膈有病，则隔拒饮食，故即以膈名病也。偏枯者，半身不遂，血气不能周通。胃病则不能纳谷，心病则不能生血，故为膈症偏枯也。）男子发左，女子发右，不喑舌转，可治。（少阴之脉侠舌本，邪未入肾，犹可治。）脉至而搏，血衄身热者死。（鼻血曰衄，亡血阴虚，脉最忌搏，身最忌热。）脉来悬钩浮，为常脉。（为邪在表，乃衄家之常脉。）（出自《大奇论》）
【灵枢】各种病都有逆证和顺证，可以听说吗？腹胀，身热，脉大，是一逆。腹鸣而满，四肢清冷泄泻，其脉大，是二逆。衄血不止，脉大，是三逆。（皆为阴症见阳脉。）咳嗽且小便血，形体脱失，其脉小劲。（小不宜劲。）是四逆。咳嗽形体脱失，身热，脉小以疾。（小不宜疾。）是谓五逆。像这样的，不超过十五日就死了。其腹部大胀，四肢清冷，形体脱失泄泻严重，是一逆。腹胀便血，其脉大时绝，是二逆。咳（上），溲血（下），形肉脱（外），脉搏动（内），是三逆。呕血，胸满引背，脉小而疾。（虚而火盛。）是四逆。咳呕（上），腹胀（中），且飧泄（下），其脉绝，是五逆。像这样的，不到一时辰就死了。（出自《玉版》）
【灵枢】什么是五逆？热病脉静。（阳症见阴脉。）汗已出，脉盛躁。（病不为汗衰。）是一逆。病泄，脉洪大，是二逆。着痹不移，肌肉破溃，身热，脉偏绝，是三逆。淫而夺形，身热，色夭然白，及后下血黑。（凝黑。）血黑重笃，是谓四逆。寒热夺形，脉坚搏。（真藏脉见。）是谓五逆。（出自《五禁》）
【灵枢】各种脉急的（脉急），多寒。脉缓的多热。（按热当属数。）脉大的多气少血。脉小的气血皆少。脉滑的阳气盛，微有热。脉涩的多血少气。（按涩当为血少。）微有寒。各种脉小的，阴阳形气俱不足。（出自《邪气脏腑病形》）
【灵枢】一日一夜五十营。（昼行阳二十五度，夜行阴二十五度。）以营养五脏之精。不应数的，名叫狂生。（犹言幸生。）所谓五十营，五脏都受气。持其脉口，数其至也。五十动而不一代的，五脏皆受气。（动而中止为代。）四十动一代的，一脏无气。三十动一代的，二脏无气。二十动一代的，三脏无气。十动一代的，四脏无气。不满十动一代的，五脏无气，予之短期。（知其将死。）（出自《根结》）
【素问】脉从而病反者，其诊何如？回答说：脉至而从，按之不鼓，诸阳皆然。（此阳盛格阴之症也。内热甚而脉反不鼓，是阳盛极，格阴于外，非真寒也。王冰注：此作非热也，下作非寒也，似与经文颠倒。）诸阴之反，其脉何如？回答说：脉至而从，按之鼓甚而盛也。（此阴盛格阳之症也。内寒而脉反鼓甚，是阴盛极，格阳于外，非真热也。二症最为惑人，医者慎之。）（出自《至真要大论》）
【素问】人迎脉大一倍于寸口，病在少阳。大二倍，病在太阳。大三倍，病在阳明。（左手寸口脉名人迎，主手足六阳经腑病。四倍以上为格阳。（一盛，人迎大于气口一倍也。仲景云：格则吐逆。王冰注：阳盛之极，格拒食不得入。东垣云：格者，甚寒之气。马莳注：格六阴在内，使不得出。）寸口脉大一倍于人迎，病在厥阴。大二倍，病在少阴。大三倍，病在太阴。四倍以上为关阴。（右手寸脉名寸口，主手足六阴经脏病。一盛，寸口大于人迎一倍也。仲景云：关则不得小便。王冰注：阴盛之极，关闭溲不得通。东垣云：关者，甚热之气。马莳注：关六阳在外，使不得入。）人迎与寸口俱盛，四倍以上为关格。关格之脉赢，不能极于天地之精气，则死矣。（新校正云：赢当作盈，乃盛极也，非羸弱也。灵枢禁服篇：寸口主内，人迎主外，两者相应，俱往俱来，若引绳大小齐等。春夏人迎微大，秋冬寸口微大，名曰平人。又终始篇：人迎一盛，病在足少阳，一盛而躁，病在手少阳。人迎二盛，病在足太阳，二盛而躁，病在手太阳。人迎三盛，病在足阳明，三盛而躁，病在手阳明。人迎四盛，且大且数，名曰溢阳，溢阳为外格。脉口一盛，病在足厥阴，一盛而躁，在手心主。脉口二盛，病在足少阴，二盛而躁，病在手少阴。脉口三盛，病在足太阴，三盛而躁，病在手太阴。脉口四盛，且大且数者，名曰溢阴，溢阴为内关。内关不通，死不治。人迎与太阴脉口俱盛，四倍以上命曰关格。关格者，与之短期。王冰素问注：言足经而不及手经。仲景东垣丹溪，皆以关格为病症。马玄台非之，而以关格为脉体。汪昂谓：若以为病症，当不止于膈食便闭二症。若以为脉体，则内经脉经及诸家经论，并无所根据，且有是脉者，必有是病，马氏何不实指其病为何等乎？）（出自《六节藏象论》）
【素问】何以知怀子之且生也？身有病而无邪脉也。（病字，王注解作经闭。汪昂按：妇人怀子，多有呕恶头痛诸病，然形虽病而脉不病，若经闭其常耳，非病也。）（出自《腹中论》）
[Suwen] The pulse is the residence of blood. (Ying Qi circulates within the vessels. *Ci Zhi Lun* states: A full pulse indicates abundant blood, while a deficient pulse indicates depleted blood.) A long pulse signifies regulated Qi. (A long pulse represents sufficient Qi.) A short pulse indicates pathological Qi. (A short pulse represents insufficient Qi.) A rapid pulse indicates vexation in the heart. (A rapid and hurried pulse indicates heat.) A large pulse indicates disease progression. (A large pulse indicates excess pathogenic factors.) Excess at the upper part (Cun position) indicates ascending Qi; excess at the lower part (Chi position), as Ma Shi notes referring to below Guan, indicates Qi distension. (Distension belongs to the middle region. Wang Ang notes: The Kidney can also have distension. The Kidney is the gate of the Stomach; if the gate is not functional, distension occurs.) A choppy or intermittent pulse (Dai pulse) indicates Qi deficiency. (The pulse beats and then stops; this is called Dai.) A thin pulse indicates Qi depletion. A choppy pulse indicates Heart pain. (A choppy pulse indicates blood deficiency.) A turbid,革 (Ge) pulse arriving like a gushing spring indicates disease progression and deteriorated complexion. A faint, continuous pulse departing like a broken string indicates death. (The pulse is faint and then ceases.) (*Mai Yao Jing Wei Lun*)
[Suwen] What are Deficiency and Excess? It is said: Excess arises from the flourishing of pathogenic factors; Deficiency arises from the depletion of essential Qi. How do they manifest? It is said: Qi deficiency corresponds to Lung deficiency. (The Lung governs Qi.) Qi rebellion manifests as cold feet. (Excess above, deficiency below.) If it occurs during a non-clashing time, there is survival; if it occurs during a clashing time, there is death. (Encountering times of Five Elements mutual overcoming.) The same applies to other Zang organs. "Chong Shi" (Double Excess) refers to severe heat diseases where Qi is hot and the pulse is full and large. When both meridians and collaterals are excess, the Cun pulse is urgent and the Chi pulse is slow. (Urgent Cun indicates Yang meridian excess; slow Chi indicates Yin collateral excess. Wang Bing notes: Yin governs collaterals, Yang governs meridians.) A slippery pulse indicates favorable prognosis; a choppy pulse indicates unfavorable prognosis. Therefore, if the five Zang organs and bones/flesh are slippery and smooth, longevity is possible. (Dead things become withered and choppy.) When collateral Qi is deficient and meridian Qi is excess, the Mai Kou (Cun position) is hot and the Chi position is cold. This is unfavorable in Autumn/Winter but favorable in Spring/Summer. Treat the primary diseased area. (In Spring/Summer, Yang Qi is high, so Mai Kou should be hot and Chi cold; observe which meridian/collateral is affected and treat accordingly.) When meridian Qi is deficient and collateral Qi is excess, the Chi pulse is full, and the Mai Kou is cold and choppy. This leads to death in Spring/Summer but survival in Autumn/Winter. (In Autumn/Winter, Yang Qi descends, so Chi should be hot and Mai Kou cold.) What is "Chong Xu" (Double Deficiency)? It is said: Upper Qi deficiency and Chi deficiency constitute Chong Xu. (Both Cun and Chi are deficient.) In such cases, a slippery pulse indicates survival, while a choppy pulse indicates death. Regarding Chang Pi (Intestinal Dysentery) with bloody stool: (Chang Feng and dysentery are both named Chang Pi. This question seems to specifically refer to dysentery, as seen below. Bloody stool refers to pure blood, caused by heat injuring the Blood level.) If the body is hot, death ensues; if cold, survival ensues. Regarding Chang Pi with white mucus discharge: (Not pus nor blood, but white mucus, caused by heat injuring the Qi level.) A deep pulse indicates survival; a floating pulse indicates death. (Floating pulse in Yin syndrome presents Yang pulse signs; generally, dysentery contraindicates body heat and floating pulse.) Regarding Chang Pi with pus and blood discharge: (Red and white mixed, injuring both Qi and Blood.) A suspended and severed pulse indicates death; a slippery and large pulse indicates survival. (Slippery represents Yin Blood; Large represents Yang Qi.) Regarding Epilepsy (Dian Ji): A pulse that is large and slippery allows for self-recovery over time. (Yang syndrome obtaining Yang pulse.) A small, firm, and urgent pulse indicates death and untreatability. (Yang syndrome obtaining Yin pulse.) Regarding the pulse of Dian Ji, what about deficiency and excess? Deficiency is treatable; excess indicates death. (Excess indicates pathogenic excess.) Regarding Xiao Dan (Wasting-Thirst, characterized by stomach heat, excessive eating, and hunger), what about deficiency and excess? A large and solid pulse in a chronic case is treatable. (Blood and Qi are still abundant.) A suspended, small, and firm pulse in a chronic case is untreatable. (*Tong Ping Xu Shi Lun*)
[Suwen] A Cun Kou pulse that feels short upon palpation indicates headache. A long one indicates pain in the shins. (Wang Bing notes: Short indicates Yang deficiency, hence disease in the head; Long indicates Yin excess, hence disease in the feet.) A Cun Kou pulse that feels rapid and strikes upward indicates shoulder and back pain. (Yang excess in the upper body.) A Cun Kou pulse that is deep and firm indicates disease in the interior. A floating and vigorous pulse indicates disease in the exterior. A Cun Kou pulse that is deep and horizontal indicates accumulation under the hypochondrium and horizontal abdominal pain. A Cun Kou pulse that is deep and panting-like indicates alternating chills and fever. (Deep is Yin, panting is Yang, indicating alternating chills and fever.) A vigorous, slippery, and firm pulse indicates exterior disease. A small, solid, and firm pulse indicates interior disease. A small, weak, and choppy pulse indicates chronic disease. (Small and weak indicate Qi deficiency; choppy indicates blood deficiency.) A slippery, floating, and rapid pulse indicates new-onset disease. (Sufficient Qi and Yang excess.) An urgent pulse indicates Hernia-Jia (masses) and lower abdominal pain. (Urgent indicates cold and pain.) A slippery pulse indicates Wind. (Slippery is a Yang pulse; Wind is also a Yang pathogen.) A choppy pulse indicates Bi Syndrome. (Choppy indicates lack of blood, hence Bi.) A slow and slippery pulse indicates Heat in the Middle. (Stomach heat.) A vigorous and tight pulse indicates distension. (Tight indicates cold distension.) A Chi pulse that is slow and choppy indicates lethargy/sluggishness. (Zhang Jingyue notes: Sluggishness.) A pulse that is vigorous while resting indicates blood loss. (While resting, the pulse should be faint; if vigorous instead, blood has departed and Qi has no master.) A Chi position that is choppy with a slippery overall pulse indicates profuse sweating. (Blood deficiency with Yang excess.) A Chi position that is cold with a fine pulse indicates posterior diarrhea. (The Kidney governs urination and defecation; deficiency-cold fails to secure.) A Chi position that is coarse and constantly hot indicates Heat in the Middle. (Wang Bing notes: Zhong refers to the Lower Jiao.) (*Ping Ren Qi Xiang Lun*)
[Suwen] If the Heart pulse beats firmly and is long, the patient will suffer from tongue retraction and inability to speak. (Beating the hand is called Bo. The tongue is the sprout of the Heart; Heart Fire excess causes this.) If the pulse is scattered, it will dissipate and heal spontaneously around the circumference. (Wang Bing notes: Scattered pulses indicate Qi excess and Blood deficiency. Xiao means dissipate; Huan means circumference. Zhang Jingyue notes: Xiao refers to Xiao Ke [Wasting-Thirst], which is incorrect here.) If the Lung pulse beats firmly and is long, the patient will expectorate blood. (Blood rebels upward following fire.) If the pulse is scattered, the patient will suffer from profuse sweating (Guan Han) and will no longer be able to undergo dispersing treatments due to fear of Yang collapse. (Ma Shi notes: Interpreting 'San' as resolving the disease is incorrect.) If the Liver pulse beats firmly and is long, but the complexion is not green, the injury is due to falling or beating. (Trauma from falling or striking; the complexion does not match the pulse, indicating external injury.) Blood stasis in the hypochondrium causes wheezing and rebellious Qi. (The Liver governs the hypochondrium; injured blood accumulates there and steams the Lung, causing wheezing.) If the pulse is scattered and the complexion lustrous, the patient suffers from Yi Yin (Overflowing Drink). Yi Yin involves sudden thirst and excessive drinking, with water fluids entering the muscles, skin, and outside the intestines/stomach. (Blood deficiency with dampness invasion, failure to metabolize fluids.) If the Stomach pulse beats firmly and is long, and the complexion is red, the patient suffers from pain in the thigh as if broken. (The Stomach meridian passes through the thigh.) If the pulse is scattered, the patient suffers from Food Bi (stagnation). (Stomach deficiency causes Bi obstruction and difficulty digesting.) If the Spleen pulse beats firmly and is long, and the complexion is yellow, the patient suffers from shortness of breath. (Spleen disharmony fails to nourish the Lung, causing Qi deficiency.) If the pulse is scattered and the complexion dull, the patient suffers from edema of the feet/shins resembling water retention. (The Spleen governs the four limbs; the meridian passes through the shins; Spleen deficiency fails to transport, causing swelling.) If the Kidney pulse beats firmly and is long, and the complexion is yellow and red, the patient suffers from waist pain as if broken. (Wang Bing notes: Yellow and red complexions indicate Heart/Spleen affecting the Kidney; the waist is the mansion of the Kidney.) If the pulse is scattered, the patient suffers from blood deficiency that does not recover. A coarse pulse indicates Yin deficiency and Yang excess, resulting in Heat in the Middle. A pulse arriving rapidly and departing slowly indicates Upper Excess and Lower Deficiency. (Rapid arrival due to Upper Excess; slow departure due to Lower Deficiency.) This indicates Jue (Reversal Cold/Heat) and Dian Ding (Vertex) diseases. (Pathogenic excess rising causes collapse and vertex ailments.) A pulse arriving slowly and departing rapidly indicates Upper Deficiency and Lower Excess, leading to aversion to wind. Thus, those struck by evil wind have their Yang Qi affected. (Wind is a Yang pathogen; Upper Deficiency makes it susceptible first.) Pulses that are all deep, fine, and scattered indicate Shaoyin Jue. (Deep and fine are Kidney pulses; rapid indicates heat. Wang Bing notes: Rapid should not appear in Chi; deep, fine, and rapid indicates Heat Jue.) Deep, fine, rapid, and scattered pulses indicate alternating chills and fever. (Deep and fine are Yin; rapid and scattered are Yang.) Floating and scattered pulses indicate collapse/fainting. (Floating indicates deficiency; scattered indicates lack of spirit.) All floating pulses without agitation are in the Yang channels, indicating heat. (Floating is Yang; floating without agitation is Yin within Yang, disease in Foot Yang meridians.) If there is agitation, it is in the Hand meridians. (Agitation implies Fire rising, Yang within Yang, disease in Hand meridians. Agitation is extreme floating.) All fine and deep pulses are in the Yin channels, indicating bone pain. (Fine and deep are Yin pulses; Yin governs bones and pain.) If there is stillness, it is in the feet. (Extreme depth indicates disease in lower Foot Yin meridians.) A rapid, moving pulse with intermittent beats (Dai) indicates disease in Yang pulses, involving diarrhea and bloody stools. (Dai indicates Qi deficiency, but stagnation can also cause Dai, hence diarrhea/blood. Ma Shi notes: Read 'Shu' as entering tone; Shu means heat, hence bloody stool, which is incorrect interpretation here.) Choppy pulses indicate Yang excess. Slippery pulses indicate Yin excess. Yang excess causes body heat and anhidrosis. (Qi abundant, Blood scarce.) Yin excess causes profuse sweating and cold body. (Yang deficient, Yin abundant.) Excess in both Yin and Yang results in anhidrosis and cold body. (Yang excess causes anhidrosis; Yin excess causes cold body.) (*Mai Yao Jing Wei Lun*)
[Suwen] Full and large Heart pulses indicate epilepsy, convulsions, and tendon cramping. (Xian Yuan sounds like han yi; Fire excess generates Wind, causing dizziness, collapse, and twitching.) Small and urgent Liver pulses indicate epilepsy, convulsions, and tendon cramping. (Small due to Blood deficiency; urgent due to Cold. Blood deficiency with Fire excess causes epilepsy; urgency causes tendon cramping.) A chaotic and violent Liver pulse after fright, with absent pulse or aphasia, will resolve spontaneously without treatment. (Violence obstructs pulses and congests Qi, causing aphasia; Qi recovery leads to spontaneous healing.) Small, urgent Kidney, Liver, and Heart pulses (without pulsation force) all indicate Jia masses. (Small and urgent indicate deficiency-cold; lack of force indicates stagnant blood, forming internal masses.) Concurrent deep Kidney and Liver pulses indicate Stone Water. (Deep indicates interior; hard abdominal distension like stone.) Concurrent floating pulses indicate Wind Water. (Floating indicates exterior; fluid retention with Wind causes edema.) Concurrent deficient pulses indicate death. (Kidney is root of five Zang; Liver is master of growth.) Concurrent small and wiry pulses indicate fear. (Wiry and small indicate deficiency.) Large, urgent, and deep Kidney and Liver pulses all indicate Shan (Hernia). (Jia and Shan are both結聚 of Cold Qi; Large indicates deficiency, Urgent indicates Cold, Deep indicates interior.) Slippery and urgent Heart pulses indicate Heart Shan. (*Mai Yao Jing Wei Lun*: Urgent Heart pulse indicates Heart Shan, tangible mass in lower abdomen, Qi rebelling to Heart.) Deep and pounding Lung pulses indicate Lung Shan. (Lung pulse should be floating; deep and pounding indicates Cold Qi invading the organ.) Urgent San Yang pulses indicate Jia; urgent San Yin pulses indicate Shan. (San Yang: Taiyang Bladder; San Yin: Taiyin Spleen. Wang Bing: Cold congealing blood forms Jia; Qi congestion forms Shan. Ma Shi: Both involve Qi and Blood.) Urgent Er Yin pulses indicate Epileptic Jue; urgent Er Yang pulses indicate Fright. (Er Yin: Shaoyin Kidney; Er Yang: Yangming Stomach. All due to Cold.) External-pulsing and deep Spleen pulses indicate Chang Pi, resolving over time. (Wu Kun notes: Deep indicates interior; external pulsing suggests emerging to exterior.) Small and slow Liver pulses indicate Chang Pi, easily treated. (Slow is Spleen pulse; Spleen overacting on Liver is mild pathogen; small/slow indicates gradual harmonization.) Small, pounding, and deep Kidney pulses indicate Chang Pi with bloody stool. (Small indicates Yin deficiency; pounding indicates Yang-heat invasion; deep indicates lower location, hence bloody stool.) Warm blood with body heat indicates death. (All dysentery, bloody stool, or mucus discharge are named Chang Pi; all contraindicate body heat.) Heart and Liver involvement also causes bloody stool. (Heart generates blood; Liver stores blood; heat transfers to intestine causing dysentery.) Simultaneous disease of these two Zang organs is treatable. (Wood and Fire generate each other.) Small, deep, and choppy Heart/Liver pulses indicate Chang Pi. (Small, deep, choppy indicates Cold dysentery.) Body heat indicates death. (Internal Yin exhaustion, external floating Yang.) Deep, pulsing, and choppy Stomach pulses. (Deep should not pulse; pulsing should not be choppy; indicates Blood deficiency with Fire.) External-pulsing and large Stomach pulses. (Yang excess, Yin insufficiency.) Small, firm, and urgent Heart pulses. (Small indicates Blood deficiency; firm indicates disharmony; urgent indicates Cold excess.) All indicate Ge (Diaphragm obstruction) and Pian Ku (Hemiplegia). (There is a diaphragm membrane between the sternum tip and 11th thoracic vertebra, separating turbid Qi from Heart/Lung. Disease here blocks food/drink, named Ge. Hemiplegia is half-body paralysis due to blocked Qi/Blood. Stomach disease prevents intake; Heart disease prevents blood generation, causing Ge and Hemiplegia.) Left-sided onset in men, right-sided in women, without aphasia and with tongue mobility, is treatable. (Shaoyin meridian flanks the tongue base; if evil has not entered Kidney, it is treatable.) Beating pulse with epistaxis and body heat indicates death. (Epistaxis is Nu; blood loss/Yin deficiency makes beating pulse taboo; body heat is taboo.) Suspended, hook-like, and floating pulses are normal pulses. (Indicates exterior pathogen, common in those with history of bleeding.) (*Da Qi Lun*)
[Lingshu] All diseases have Ni (Rebellious/Adverse) and Shun (Smooth/Favorable) patterns. Can you explain? Abdominal distension, body heat, and large pulse constitute the first Ni. Abdominal rumbling and fullness, cold limbs, diarrhea, and large pulse constitute the second Ni. Unstopping epistaxis and large pulse constitute the third Ni. (All are Yin syndromes presenting Yang pulses.) Cough with hematuria, emaciation, and small but forceful pulse constitutes the fourth Ni. (Small should not be forceful.) Cough with emaciation, body heat, and small but rapid pulse constitutes the fifth Ni. (Small should not be rapid.) Such patients die within fifteen days. Severe abdominal distension, cold extremities, emaciation, and severe diarrhea constitute the first Ni. Abdominal distension with bloody stool, large pulse with intermittent cessation constitutes the second Ni. Cough (upper), hematuria (lower), emaciation (external), and beating pulse (internal) constitute the third Ni. Hematemesis, chest fullness radiating to back, small and rapid pulse constitutes the fourth Ni. (Deficiency with Fire excess.) Cough/vomiting (upper), abdominal distension (middle), and undigested food diarrhea (lower) with absent pulse constitute the fifth Ni. Such patients die within one double-hour. (*Yu Ban*)
[Lingshu] What are the Five Nis? Heat disease with quiet pulse (Yang syndrome presenting Yin pulse) is the first Ni. Sweating followed by vigorous and restless pulse (disease not subsiding with sweat) is the first Ni. Diarrhea with洪大 (Hong Da/Great) pulse is the second Ni. Fixed Bi with immobility, muscle wasting, body heat, and unilateral absent pulse is the third Ni. Chronic disease with emaciation, body heat, pale and dull complexion, and subsequent black bloody stool is the fourth Ni. Cold/Heat disease with emaciation and firm, grasping pulse (True Zang pulse appearance) is the fifth Ni. (*Wu Jin*)
[Lingshu] Urgent pulses generally indicate Cold. Slow pulses generally indicate Heat. (Note: Heat should correspond to Rapid.) Large pulses indicate Qi excess and Blood deficiency. Small pulses indicate both Qi and Blood deficiency. Slippery pulses indicate Yang abundance with slight heat. Choppy pulses indicate Blood excess and Qi deficiency with slight cold. (Note: Choppy should indicate Blood deficiency.) Small pulses in all categories indicate deficiency of Yin-Yang, Form, and Qi. (*Xie Qi Zang Fu Bing Xing*)
[Lingshu] One day and night consists of fifty circuits. (Day travels Yang twenty-five degrees; Night travels Yin twenty-five degrees.) To nourish the essence of the five Zang organs. Those not matching the number are called "Kuang Sheng" (Fortuitous Survival). The so-called fifty circuits mean all five Zang receive Qi. Hold the Mai Kou and count the beats. Fifty beats without a single Dai (intermittent) beat means all five Zang receive Qi. (Stopping mid-beat is Dai.) Forty beats with one Dai beat means one Zang lacks Qi. Thirty beats with one Dai beat means two Zang lack Qi. Twenty beats with one Dai beat means three Zang lack Qi. Ten beats with one Dai beat means four Zang lack Qi. Less than ten beats with one Dai beat means five Zang lack Qi, giving a short-term prognosis (knowing death is imminent). (*Gen Jie*)
[Suwen] What is the diagnosis when the pulse conforms but the disease contradicts? It is said: The pulse appears conforming, but pressing it reveals no pulsation force; this applies to all Yang conditions. (This is Yang Excess repelling Yin. Internal heat is severe, yet the pulse does not surge; this is extreme Yang excess repelling Yin to the exterior, not true Cold. Wang Bing notes: This interprets as 'not heat', and below 'not cold', seemingly reversing the text.) What about the contradiction in Yin conditions? It is said: The pulse appears conforming, but pressing it reveals vigorous pulsation. (This is Yin Excess repelling Yang. Internal cold is severe, yet the pulse surges vigorously; this is extreme Yin excess repelling Yang to the exterior, not true Heat. These two conditions are most confusing; physicians must be cautious.) (*Zhi Zhen Yao Da Lun*)
[Suwen] Ren Ying pulse one-fold larger than Cun Kou indicates disease in Shaoyang. Two-fold indicates Taiyang. Three-fold indicates Yangming. (Left hand Cun Kou named Ren Ying, governing Six Yang meridians/zang-fu. Four-fold or more indicates Ge Yang. (One-fold: Ren Ying is one times larger than Qi Kou. Zhang Zhongjing: Ge implies vomiting/regurgitation. Wang Bing: Extreme Yang excess repels food entry. Dong Yuan: Ge is extreme cold qi. Ma Shi: Ge keeps six Yins inside, preventing exit.) Cun Kou pulse one-fold larger than Ren Ying indicates disease in Jueyin. Two-fold indicates Shaoyin. Three-fold indicates Taiyin. Four-fold or more indicates Guan Yin. (Right hand Cun named Cun Kou, governing Six Yin meridians/zang. One-fold: Cun Kou is one times larger than Ren Ying. Zhang Zhongjing: Guan implies urinary retention. Wang Bing: Extreme Yin excess closes passage, preventing urination. Dong Yuan: Guan is extreme heat qi. Ma Shi: Guan keeps six Yangs outside, preventing entry.) When Ren Ying and Cun Kou are both excessive, four-fold or more indicates Guan Ge. The Guan Ge pulse is盈 (Ying/Full/Extreme), unable to reach the essence of Heaven and Earth, leading to death. (New Correction: Ying should be written as 盈, meaning extreme fullness, not 羸 [weak]. Lingshu Jin Fu: Cun Kou governs interior, Ren Ying exterior; they should correspond... Spring/Summer Ren Ying slightly large, Autumn/Winter Cun Kou slightly large is Ping Ren [Normal Person]. Also Zhong Shi: Ren Ying one-fold, disease Foot Shaoyang... Ren Ying four-fold, large and rapid, named Yi Yang, Yi Yang is External Ge. Pulse Kou one-fold, disease Foot Jueyin... Pulse Kou four-fold, large and rapid, named Yi Yin, Yi Yin is Internal Guan. Internal Guan unblocked, death untreatable. Ren Ying and Taiyin Pulse Kou both four-fold large is Guan Ge. Guan Ge gives short-term prognosis. Wang Bing Suwen Zhu: Mentions foot meridians only. Zhang Zhongjing, Dong Yuan, Dan Xi all treat Guan Ge as a disease. Ma Xuantai opposes this, treating it as a pulse form. Wang Ang argues: If disease, it shouldn't be limited to dysphagia/constipation. If pulse form, Neijing/Mai Jing lack basis. Having this pulse implies having this disease; why doesn't Ma specify?) (*Liu Jie Zang Xiang Lun*)
[Suwen] How to know pregnancy is near delivery? The body has symptoms (illness) but the pulse is not pathological. (Wang Bing interprets 'Bing' as amenorrhea. Wang Ang notes: Pregnant women often have nausea, headache, etc. Though the body shows illness signs, the pulse is normal. Amenorrhea is usual, not illness.) (*Fu Zhong Lun*)
[Suwen] If a woman's Hand Shaoyin pulse is vigorous/moving, she is pregnant. (Wang Bing interprets as having a child. Ma Shi interprets as male fetus. Wang Ang notes: This likely refers to the time of impending labor. Hand Shaoyin refers...)